Many people come to therapy for reasons unrelated to substance use, such as anxiety, relationship stress, burnout, grief, or major life transitions. At some point, though, a question often comes up:
“Is my drinking a problem?”
“Do I smoke too much weed?”
These questions rarely come from nowhere. They often arise when someone notices a shift, like using alcohol or cannabis more often, relying on it to unwind, or feeling uneasy about how it fits into their life.
Importantly, many people feel ambivalent about their relationship to substances. They may enjoy aspects of it and also feel uncertain or uncomfortable about how much they rely on it. Therapy can hold both of these truths at the same time, without rushing toward a conclusion.
Rather than approaching these questions through a lens of “good” or “bad,” therapy offers a more useful framework: function and impact.
Moving Away from “Good” vs. “Bad”
Substance use exists on a wide spectrum. Two people can use the same amount and experience very different outcomes, so therapy focuses on function and impact rather than judgments.
In sessions, we often explore questions like:
- What role does this substance play for you?
- What does it help you cope with in the moment?
- Is it offering relief, connection, calm, confidence, or rest, especially when those things are hard to come by in other ways?
From this perspective, substance use is not automatically a problem; it is information. It can offer insight into what someone is managing internally and what support they may need.
Why Impact Matters
Another important part of the conversation is impact. This includes both external and internal signs that something may be worth exploring further.
External impact might include substance use interfering with work, relationships, health, or personal goals, or receiving comments from others. Internal impact can be more subtle: changes in mood, sleep, motivation, anxiety levels, or how present someone feels in their daily life.
These questions are not about judgment. They help clarify whether a coping strategy that once worked may be creating new difficulties.
Substance Use as a Signal
Often, substance use is not the core issue, but a signal of something larger. People may turn to substances in response to anxiety, sadness, chronic stress, grief, loneliness, or periods of transition that leave them feeling unsteady. In many cases, this reflects underlying emotional pain. Substance use also commonly intersects with co-occurring mental health conditions, rather than existing in isolation.
Seen this way, substance use can be understood as a coping strategy. Therapy offers space to understand what someone is responding to and to build additional tools that support well-being.
Importantly, exploring substance use does not mean being told what to do. Clients remain in control of their goals, whether that means changing patterns, reducing use, or simply understanding them better. These conversations often happen alongside work on emotions, relationships, or life stressors in individual therapy, rather than as a separate or defining issue.
How Therapy Can Help
Talking about substance use in therapy does not require a diagnosis, a crisis, or a commitment to abstinence. Instead, sessions provide a collaborative, nonjudgmental space, often informed by approaches such as cognitive behavioral therapy (CBT), to:
- Explore what substance use does for you
- Understand how it may be impacting you
- Identify underlying emotional or situational stressors
- Develop coping strategies that align with your values and priorities
If questions about substance use are coming up for you, therapy can offer a supportive space to explore them at your own pace. You don’t need a diagnosis or a crisis to start the conversation. Reaching out can be a first step toward greater clarity and support. Contact us to learn more about scheduling an appointment.